Introduction
Kidney failure is a common condition in cats as they age. It occurs when the kidneys can no longer adequately filter toxins and waste products from the blood. This results in the buildup of harmful substances in the body. There are two main types of kidney failure in cats – acute and chronic. Acute kidney failure happens suddenly, while chronic kidney failure progresses over months or years.
Fluids play a critical role in the treatment of kidney failure in cats. Fluid therapy helps flush toxins from the body and prevent dehydration. For cats with acute kidney failure, aggressive fluid therapy can potentially reverse the condition if treated early enough. For chronic kidney failure, ongoing fluid administration helps manage the symptoms and slow further kidney damage.
This article provides an overview of kidney failure in cats, explores the importance of fluid therapy, and offers guidance on safely administering fluids at home. The goal is to help cat owners understand when fluid treatment may be recommended and how to provide the best care for a cat with compromised kidney function.
What Causes Kidney Failure in Cats?
There are two main types of kidney failure in cats – chronic kidney disease and acute kidney injury. Chronic kidney disease (CKD) is the most common cause of kidney failure in older cats. CKD is a gradual deterioration of kidney function that worsens over months or years. It is often caused by underlying conditions like high blood pressure, infections, toxins, or dental disease. Eventually the kidneys struggle to remove waste products from the blood and maintain normal fluid balances in the body (VCA Hospitals).
Acute kidney injury (AKI) involves a sudden loss of kidney function over several days or weeks. Common causes of AKI include ingesting toxins like antifreeze, certain medications or supplements, urinary obstruction, and decreased blood flow to the kidneys. AKI causes the kidneys to suddenly lose their filtering ability. Without treatment, AKI can quickly lead to a life-threatening buildup of waste products in the blood (Guilford-Jamestown Vet).
In both cases, when kidney function declines below a certain point, dangerous levels of waste and toxins can accumulate, leading to a diagnosis of kidney failure. Early detection and treatment is key to support kidney function and slow further deterioration.
Signs of Kidney Failure
There are several common signs of kidney failure in cats to look out for. As the kidneys lose their ability to function properly, toxins build up in the bloodstream and the body struggles to regulate fluids and electrolytes.
One of the earliest signs is increased thirst and urination. Cats with failing kidneys cannot concentrate urine effectively, so they may drink more water trying to compensate. You may notice your cat drinking more water than usual or having accidents outside the litter box as they urinate more frequenty.
Significant weight loss is another key symptom of kidney failure in cats. When the kidneys cannot filter waste properly, this can cause poor appetite and muscle wasting. Vomiting, diarrhea, and oral ulcers may also contribute to weight loss.
Lethargy and depression are common as toxins accumulate in the blood and the cat feels unwell. You may notice your once-active cat sleeping more and seeming withdrawn.
Other symptoms include bad breath from ulceration in the mouth, vomiting, diarrhea, and loss of bowel control. Unkempt fur, dull eyes, and pale or reddened gums may also indicate your cat is unwell.
In advanced kidney failure, symptoms can include inability to walk, seizures, coma, and fluid buildup. At end-stage, the symptoms become severe as the body shuts down.
If you notice any combination of these symptoms in your cat, take them to the vet immediately for blood and urine testing. Early diagnosis and treatment is key for kidney disease in cats.
[Sources: https://www.lakecross.com/site/blog-huntersville-vet/2020/11/05/symptoms-kidney-failure-cats]
Diagnosing Kidney Failure
Kidney disease is often first detected through routine blood and urine tests. Blood tests like BUN (blood urea nitrogen) and creatinine levels can indicate impaired kidney function if they are elevated (vet.cornell.edu).
Urinalysis is another key diagnostic tool. It can detect decreased urine concentrating ability, protein loss, and increased cellularity. The urine protein to creatinine (UPC) ratio helps quantify how much protein is being lost in the urine, which is common in kidney disease (petmd).
Imaging techniques like x-rays, ultrasound, or CT scans may be used to evaluate the kidneys. These can detect abnormalities in kidney size, shape, and structure. Ultrasound can also look for kidney stones (vcahospitals.com).
Finally, biopsy of the kidney may be done in some cases to evaluate the underlying cause and degree of damage. This is an invasive procedure but can provide important diagnostic information (petmd.com).
Treatment Options
There are several treatment options for cats with kidney failure. The main goals are to resolve abnormalities found in bloodwork, manage clinical signs, slow disease progression, and maintain quality of life.
One of the most common treatments is administration of intravenous or subcutaneous fluids, which helps correct dehydration and flush toxins from the body. Fluids improve blood flow to the kidneys and can be given at home or by your veterinarian (VCA Animal Hospitals).
Changing to a kidney-friendly diet low in phosphorus and protein is often recommended, as excess phosphorus can worsen kidney damage. Prescription kidney diets provide optimal nutrition. Phosphate binders may also be used (PetMD).
Anti-nausea medications like Cerenia can help with appetite issues. Medications to control blood pressure, like amlodipine, may be prescribed for hypertension. Monitoring blood levels and making dosage adjustments is important.
Additional supplements, antibiotics, and medications may be used to manage complications and clinical signs on a case-by-case basis under veterinary supervision.
The Role of Fluids in Kidney Failure
Fluids play a crucial role in managing kidney failure in cats. As the kidneys fail, they lose their ability to concentrate urine and excrete waste products from the bloodstream. This allows toxins like urea and creatinine to build up in the body, leading to symptoms like vomiting, diarrhea, and loss of appetite [1].
Administering fluids helps flush these toxins out of the body and offsets dehydration. There are two main methods for giving fluids: subcutaneous (under the skin) and intravenous (into the veins). Subcutaneous fluids are commonly given at home by pet owners and involve inserting a small needle under the skin between the shoulder blades. Fluids are provided in measured doses based on the cat’s needs. This helps hydrate the cat and supply important nutrients like electrolytes [2].
Intravenous fluids involve inserting a catheter into a vein and providing fluids directly into the bloodstream. This method is faster and more intensive, allowing larger volumes of fluids. It is typically used in a veterinary clinic for cats in acute kidney failure or when subcutaneous fluids are insufficient [3]. With either method, carefully monitored fluid therapy helps remove toxins, improves kidney function, and supports cats with kidney disease.
Tips for Giving a Cat Fluids
Here are some tips for administering subcutaneous fluids at home to cats with kidney disease:
Equipment Needed:
- Fluid bags or bottles prescribed by your veterinarian
- Subcutaneous needles or butterfly catheter
- Alcohol pads to disinfect the skin
- Clippers to shave the area if needed
- Fluid line and stand if using bags
Amount and Frequency:
The amount and frequency of fluids will be determined by your veterinarian based on your cat’s needs. Typically cats may need 100-150 mL 1-2 times per day. Your vet will show you how to administer the proper dosage.
Technique:
The fluids are administered under the skin typically on the back between the shoulder blades. Gently pinch the skin and insert the needle parallel to the body. Secure the line in place and adjust the flow rate as needed. The fluids should form a bump under the skin. Massage the area to help distribute the fluids.
Make the procedure as calm and stress-free as possible. Give your cat treats and affection. Monitor for discomfort. Contact your vet if any swelling, bleeding, or reactions occur.
Be sure to keep the supplies clean. Recap needles carefully. Dispose of waste properly. Keep track of dates and amounts given.
With practice, many cat owners find the routine manageable. Working closely with your vet ensures your cat gets the fluids they need.
Sources:
https://vcahospitals.com/know-your-pet/subcutaneous-fluid-administration-in-cats
https://icatcare.org/advice/how-to-give-subcutaneous-fluids-to-your-cat/
Monitoring and Adjusting Fluid Therapy
It’s important to monitor your cat closely while they are on at-home fluid therapy. This allows you to gauge whether the fluids are helping and make adjustments as needed. Some signs to look for include:
- Increased thirst and urination – This generally indicates the fluids are working to flush toxins from the body.
- Improved appetite – Fluids can help reduce nausea and make cats feel better overall.
- Increased energy levels and activity – Your cat may seem more lively as fluids improve how they feel.
- Reduced vomiting – Fluids help with electrolyte imbalances that can cause vomiting.
- Stable weight – Fluid therapy helps prevent dehydration and weight loss.
You should also continue monitoring bloodwork regularly, such as BUN and creatinine levels, to see objective improvement in kidney values (Langston, 2021).
If your cat seems to tolerate the fluids well, your veterinarian may adjust the dose and frequency. Giving more fluids can provide greater benefits, but too much can also be detrimental. Work closely with your vet to find the optimal fluid plan for your cat.
Let your vet know right away if you notice any problems, like fluid leaking from the injection site, redness and inflammation around the area, or changes in behavior after receiving fluids. Your vet may adjust the dose, frequency, or fluid type accordingly.
Considerations and Risks
While fluids can be very beneficial for cats with kidney failure, there are some risks and considerations to keep in mind.
Giving too much fluid too quickly can lead to fluid overload, causing pulmonary edema (fluid in the lungs) and congestive heart failure (Langston, 2021). Careful monitoring and gradual increases in fluids are important.
In some cases, fluids may not help cats with very advanced kidney disease. If the kidneys are no longer able to eliminate waste products and regulate electrolytes, fluids cannot reverse this (VCA Hospitals).
Older cats with kidney disease often have other age-related conditions that may complicate fluid therapy. Conditions like heart disease, hypertension, and cognitive dysfunction need to be managed alongside kidney disease.
Some cats dislike the administration of fluids and may experience stress or discomfort, especially during the learning curve. Pet owners need proper training on giving fluids safely and making it a low-stress experience.
Overall, the benefits of fluids tend to outweigh the risks when properly administered under veterinary supervision. However, individual factors need to be weighed on a case-by-case basis.
The Outlook for Cats on Fluids
The prognosis for cats with kidney failure receiving fluid therapy varies depending on the stage of kidney disease and other factors. However, fluids can significantly improve quality of life and may extend lifespan in many cases.
According to a 2021 review, subcutaneous fluid administration is associated with prolonged survival times in cats with kidney failure (Langston et al.). With aggressive fluid therapy, some cats may survive over a year after diagnosis. Fluids help remove waste products from the blood, maintain hydration, and support kidney function.
While fluids cannot cure kidney failure, they can stabilize the condition and minimize symptoms like vomiting, diarrhea, and loss of appetite. With close monitoring and adjustments to fluid volume, cats can often maintain a good quality of life on fluid therapy. However, kidney function will continue to deteriorate over time.
The outlook is better for cats diagnosed and started on fluids early in the course of kidney disease. Cats with advanced kidney failure or other health issues generally have a shorter survival time. Talk to your veterinarian about your cat’s individual prognosis.